Effect of Non-vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients with Newly Diagnosed Cancer
- Author:
Kyu KIM
1
;
Yong Joon LEE
;
Tae Hoon KIM
;
Jae Sun UHM
;
Hui Nam PAK
;
Moon Hyoung LEE
;
Boyoung JOUNG
Author Information
- Publication Type:Original Article
- Keywords: Atrial fibrillation; Hemorrhage; Neoplasms; Stroke; Anticoagulants
- MeSH: Anticoagulants; Atrial Fibrillation; Diagnosis; Embolism; Follow-Up Studies; Hemorrhage; Humans; Incidence; International Normalized Ratio; Propensity Score; Research Design; Stroke; Warfarin
- From:Korean Circulation Journal 2018;48(5):406-417
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND OBJECTIVES: There are limited data on the use of non-vitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients with cancer. We aimed to assess the efficacy and safety of NOACs in AF patients with cancer in this study. METHODS: In 2,568 consecutive non-valvular AF patients with newly diagnosed cancer, we analyzed ischemic stroke/systemic embolism (SE), major bleeding, and all-cause death. Based on propensity score matching, 388 matched pairs were included in the NOAC and warfarin groups. RESULTS: Patient baseline characteristics were comparable between the matched groups. During median follow-up of 1.8 years, the NOAC group had significantly lower incidences of ischemic stroke/SE (p < 0.001), major bleeding (p < 0.001), and all-cause death (p < 0.001) than the warfarin group. Moreover, the incidence of major bleeding was significantly lower in the NOAC group than in the warfarin group with optimal international normalized ratio control (p=0.03). Especially, within 1 year after cancer diagnosis, the incidences of all clinical events were significantly lower in the NOAC group than in the warfarin group. CONCLUSIONS: In AF patients with newly diagnosed cancer, NOACs showed lower incidences of ischemic stroke/SE, major bleeding, and all-cause death than warfarin, especially within 1 year after cancer diagnosis.
